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19 E Mountain St Ste 12 Fayetteville AR 72701-6067 | |
| (479) 601-7577 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 19 E Mountain St Ste 12, Fayetteville, Arkansas |
| Authorized Official Name and Position | Catherine Dimakatso Kabasia-sello (THERAPIST/OWNER) |
| Authorized Official Contact | 4796017577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
19 E Mountain St Ste 12 Fayetteville AR 72701-6067 Ph: (479) 601-7577 | 19 E Mountain St Ste 12 Fayetteville AR 72701-6067 Ph: (479) 601-7577 |
| NPI Number | 1043896913 |
|---|---|
| Provider Enumeration Date | 03/22/2021 |
| Last Update Date | 03/26/2021 |
| Certification Date | 03/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043896913 | NPI | - | NPPES |
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